Individual
MR. BRENT MICHAEL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
34 SW 89TH ST, OKLAHOMA CITY, OK 73139-8510
(405) 488-0750
(405) 488-0761
Mailing address
34 SW 89TH ST, OKLAHOMA CITY, OK 73139-8510
(405) 488-0750
(405) 488-0761
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
APA2052
OK
Other
Enumeration date
12/19/2011
Last updated
12/19/2011
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